ECMO
Reading File
Finding Sources
Finding Sources
Searching PubMed
ECMO
Searching the Web
ECMO Extracorporeal Life Support Organization patient education overview
Reading File
Reading File
ECMO means extracorporeal membrane oxygenation. It is temporary, advanced life support used in an ICU when the lungs, heart, or both cannot provide enough oxygen delivery despite maximal conventional treatment.
How it works
Blood is drained through a large cannula, pumped through an artificial lung (membrane oxygenator) that adds oxygen and removes carbon dioxide, then returned to the patient. This can allow the injured lungs or heart time to recover, or serve as a bridge to a transplant, ventricular-assist device, or another decision.
Main configurations
| Type | Supports | Typical use |
|---|---|---|
| VV-ECMO (veno-venous) | Lungs only | Severe, potentially reversible respiratory failure, particularly severe ARDS |
| VA-ECMO (veno-arterial) | Heart and lungs | Cardiogenic shock, severe cardiac failure, selected refractory cardiac arrest, or failure to separate from cardiopulmonary bypass |
VV-ECMO does not provide circulatory support, so a patient with significant heart failure generally needs a different configuration. Severe ARDS with profound hypoxemia despite optimized ventilation is a common VV-ECMO scenario. Miller's Anesthesia, p. 12110.
Important points
- ECMO is not a cure. It supports gas exchange and/or circulation while the underlying cause is treated.
- It is delivered in specialized, multidisciplinary centers.
- Patients usually require close monitoring, anticoagulation management, mechanical ventilation adjustments, infection prevention, and assessment for recovery or futility.
- Major complications include bleeding, blood clots or circuit thrombosis, stroke or other neurologic injury, infection, kidney injury, hemolysis, limb ischemia with peripheral VA-ECMO, and cannula-related injury. Complication risk is generally higher with VA than VV support.
For adult respiratory failure, evidence supports referral to an experienced ECMO center in carefully selected severe cases, rather than routine use for all ventilated patients. Miller's Anesthesia, pp. 12109-12110. A recent systematic review of adult respiratory ECMO is indexed as PMID 39710591.
The ELSO organization maintains ECMO education, registry data, and professional resources.
This is a shared conversation. Sign in to Orris to start your own chat.